Customer Feedback

100% of survey complete.

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* 1. What date did you visit our office?

Date in office:

Date

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* 2. Which office did you visit today?

Blountstown

Chipley

Marianna

Panama City

Port St. Joe

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* 3. Please rate the services you received today. Choose N/A if you did not receive the services during your visit today.

	Very Positive	Positive	Neutral	Negative	Very Negative	N/A
Your overall visit today	Your overall visit today Very Positive	Your overall visit today Positive	Your overall visit today Neutral	Your overall visit today Negative	Your overall visit today Very Negative	Your overall visit today N/A
Child Care Resource and Referral (CCR&R) Services	Child Care Resource and Referral (CCR&R) Services Very Positive	Child Care Resource and Referral (CCR&R) Services Positive	Child Care Resource and Referral (CCR&R) Services Neutral	Child Care Resource and Referral (CCR&R) Services Negative	Child Care Resource and Referral (CCR&R) Services Very Negative	Child Care Resource and Referral (CCR&R) Services N/A
Eligibility Determination	Eligibility Determination Very Positive	Eligibility Determination Positive	Eligibility Determination Neutral	Eligibility Determination Negative	Eligibility Determination Very Negative	Eligibility Determination N/A
Child Liasion Appointment	Child Liasion Appointment Very Positive	Child Liasion Appointment Positive	Child Liasion Appointment Neutral	Child Liasion Appointment Negative	Child Liasion Appointment Very Negative	Child Liasion Appointment N/A
VPK Appointment	VPK Appointment Very Positive	VPK Appointment Positive	VPK Appointment Neutral	VPK Appointment Negative	VPK Appointment Very Negative	VPK Appointment N/A

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* 4. Does having School Readiness services for your child(ren) allow you to maintain/obtain employment or further your education?

Yes

No

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* 5. How likely would it be for you to obtain/maintain employment or further your education if you DID NOT have School Readiness services?

I could not do it.

It would be difficult for me to do it.

I could do it.

I do not really need School Readiness services.

Question Title

* 6. Did somebody do something really good today? Maybe something not so good happened... now is your chance to let us know. We appreciate your comments.